Registration Form

Registration for each Orientation is limited to 15 students, so register early.

Name:

Student ID Number:

Email Address:

Primary Phone Number:

Alternate Phone Number:

Address:

City:

State:

Zip:

Number(s) of Guest(s)1   2   3

Intended Major/Career Program:

I will be attending New Student Orientation scheduled for:
Wednesday, April 7, 2010
Tuesday, April 13, 2010
Tuesday, April 20, 2010
Wednesday, April 28, 2010
Thursday, May 6, 2010
Tuesday, May 11, 2010
Tuesday, June 15, 2010
Wednesday, June 23, 2010
Tuesday, June 29, 2010
Tuesday, July 13, 2010
Wednesday, July 21, 2010
Tuesday, July 27, 2010

Questions Regarding 'New Student Orientation' Contact?
  Renee Gregory, Intake Specialist
  913-288-7457